Gestational diabetes mellitus (GDM), defined by the occurrence or discovery of glucose intolerance during pregnancy is associated with higher risk of perinatal complications and long-term development of chronic diseases both in the mother and her child. Recent data suggest that women diagnosed earlier in pregnancy, even having more risk factors, develop fewer complications. The aim of the current study is to analyse biochemical markers that play a role in the pathophysiology of GDM and could lead to an early diagnosis. The authors performed a case-control study on 50 pregnant women that finally developed GDM and 50 pregnant women with risk factors for GDM which did non develop the disease. In all cases there were monitored a series of biochemical markers like glycated haemoglobin (HbA1c), sex hormone binding globulin (SHBG), magnesium (Mg), C-reactive protein (CRP), plasma insulin level, and pregnancy-associated plasma protein A (PAPP-A). All these factors were statistically analysed using univariate and multivariate tests in order to evaluate their predicting value. The combination of traditional risk factors with HBA1c, SHBG, PAPP-A and CRP proved significant prognosis value (75% sensitivity rate, 9% false positive rate) for GDM. In conclusion, these four biochemical markers available in early pregnancy have improved the performance of predicting models concerning the development of severe GDM needing insulin treatment and predisposing to maternal and foetal complications.

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The study aims to assess the significance of negative pressure therapy in the treatment of 1 January 2014 - 31 June 2017. The objectives intend to evaluate the healing time required after applying the method and the functional consequences for the patient. A prospective study was conducted on a sample of 31 patients with various tipe of wounds which were monitored their clinical course between September 2014 - February 2017, following negative pressure therapy. There were used vacuum assisted closure devices (VAC � -Hartman) in order to apply negative pressure to the wound, while complying with specified settings in accordance with patients� outcome. Healing was obtained in all cases, to an average hospital stay of 30 days and 12 days of therapy application.The negative result of microbial cultures was obtained after an average of 7.55 days by simultaneous application of negative pressure and antibiotic treatment according to the antibiogram. After basic treatment of the wound, auxiliary methods such as negative pressure contribute to the healing. Evolution was favorable with wound granulation in 95% cases, which allowed surgery under local anesthesia, and defect was covered with skin graft. VAC therapy falls into the last group of treatments by eliminating healing inhibitors. This regenerates the wound in a damp environment and essentially turns an open wound into a closed system.

Chorioamnionitis or intra-amniotic infection is an infection that affects the intrauterine content during pregnancy. Numerous studies have reported vaginal colonization with various types of infectious agents as a risk factor for chorioamnionitis. Although this complication occurs due to the ascending polymicrobial bacterial infection at the time of membrane breakage, it may also occur in pregnant women with intact membranes, mainly due to Ureaplasma urealyticum (U. urealyticum) and Mycoplasma hominis (M. hominis). The main aim of the present study was to identify a region-specific panel of infectious agents that can be used more accurately determine premature birth, as well as the premature rupture of membranes (PROM). Thus, a 10-year retrospective study was conducted. A total of 1,301 pregnant women with PROM and premature birth or spontaneous abortion were included in the study. It was observed that the main infectious agent varied in the five groups analyzed in total. The infectious agent distribution also varied depending on environmental parameters. Ureaplasma was found to be the most frequently detected germ amongst the infectious agents of the vaginal cultures from pregnant women enrolled in the present study, regardless of gestational age. On the whole, the findings of the present study suggest that additional studies are required, in order to confirm that diagnosis and treatment according to laboratory results of vaginal infections with U. urealyticum/M. hominis during the first trimester of pregnancy could prevent premature birth, abortion or chorioamnionitis.

The purpose of this study was to evaluate first trimester biochemical screening benefit with and without adding NT in enlarged measurements on screening performances. Methods: Nine thousands five hundreds and twenty-three patients underwent first trimester screening performing NT measurement and first trimester serum screening. Clinical management was decided on the basis of NT/biochemistry risk calculation. Retrospectively enlarged NT were evaluated and risk calculation was evaluated with and without NT measurements when above 2.0 MoM. Results: One hundred and seven fetuses presented at 11-14 weeks' gestation NT measurement above 2.0 MoM. 87 presented positive ultrasound-biochemical screening whilst only 21 had a positive risk calculation using only PAPP-A and free beta hCG. 24 patients were lost at follow-up. The whole population with adverse obstetric outcome (27 patients) where within the 87 with combined screen positive (Detection rate 100%; 87-100% CI 95%), while only nine were detected by biochemical screen (Detection rate 33%; 17-54% CI 95%). Seven cases of trisomy 21 were identified by combined screen (Detection rate 100%; 59-100% CI 95%) and only five by biochemistry alone (detection rate 71%; 29-96% CI 95%). Conclusions: NT measurements above 2.0 MoM increase significantly the risk from biochemistry having 4 times positive screen patients. Whilst an increase of OAPR, the detection rate is reduced significantly not considering NT measurements above 2.0 MoM. Larger population is needed in order to confirm our population result and screening policy.